When Dr. Adam Kassam talks about how Ontario’s health-care system changed to meet the demands of the COVID-19 pandemic, he uses a simple adage.
“Innovation is born out of necessity,” he told iPolitics in an interview on Monday.
Kassam is the new president of the Ontario Medical Association (OMA), an influential advocacy organization that represents 43,000 physicians across the province. A 33-year-old rehabilitation specialist at Runnymede Healthcare Centre in Toronto, Kassam is the youngest person to ever lead the OMA, a role he assumed last month during the worst health crisis in a century.
And while that crisis has strained the province’s health system over the last year, Kassam believes it has a chance to come out stronger and more resilient on the other side.
“It’s a significant opportunity for transformation,” he said. “There’s no question that this has been one of the largest, if not the largest, convulsions in our health-system burden in 100 years.”
But before that transformation can happen, Ontario needs to emerge from the worst of the pandemic, Kassam said. That means getting people fully vaccinated as quickly as possible, and maintaining the drop in hospitalizations and admissions to intensive care.
“This is all governed by health-care capacity,” he said. “If we continue to see those trends stay low, then we can start putting in place strategies to really effect transformative change in our health-care system.”
One way Kassam thinks Ontario can keep the momentum going is by making primary-care physicians across the province a “significant pillar” of Ontario’s vaccination campaign from now on.
Currently, the vast majority of doses are administered at mass vaccination clinics and in pharmacies. But now that the shots don’t need to be stored in extreme cold, it’s easier for physicians to store them in their offices. It therefore makes sense to give doctors a bigger role in any vaccination campaign.
“Seventy per cent of all flu shots are given by family doctors and primary-care physicians across the province, and it’s very successfully done,” he said.
Freeing up space in the health system in the coming months will also be a crucial first step in getting out from under a backlog of 16 million health procedures, including surgeries, that’s been building since before the pandemic.
In a briefing last week, Kassam and his colleagues told reporters it would take the system working at 120 per cent capacity for more than a year to clear most of the backlog, with different timelines for different procedures.
But if the health system operates at over-capacity to reduce the backlog, it won’t be a “sustainable workflow” for physicians who’ve been working overtime throughout the pandemic, Kassam said.
That means Ontario’s government will need to step up with sustainable, long-term funding to support the sector, while it manages the backlog and positions itself for a transformation. And Kassam sees evidence all around him that change is possible.
He uses the example of how the hospital where he works quickly increased its capacity to meet the demands of the pandemic.
When hospitals in Toronto were scrambling to add beds, Kassam’s rehabilitation unit at Runnymede was reorganized to accept patient transfers so more space could be made in other hospitals for sicker patients.
“We had patients who were in physiotherapy gyms, who would otherwise normally be using that physiotherapy gym for their therapy,” Kassam said. “We had places like the kitchens, where people would congregate and meet for food and for drinks, but they converted those into beds.”
The experience has given Kassam resolve that a lot more is possible.
“Our capacity to transform — and to really innovate, to load-share, to reorganize at a drop of the hat — was shown to be possible in this pandemic,” he said. “We should extend that philosophy and the knowledge we’ve gained over the past 15 months for a broader health-system transformation in the future.
“(We need) to have a sustainable, efficient, and effective system into the future for Ontarians.”
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